Monday, November 21, 2011

What the health is wrong with "personal responsibility"?

Discussion of the individual mandate for health insurance has been swirling for quite a long time from debates over healthcare reform at state and federal levels or a point of political criticism by fellow candidates in the upcoming presidential primaries. It's not only that liberals approve of it, such as in the passage of Obamacare or in in candidate Hillary Clinton's plans. Republicans and conservative groups have expressed support for an individual mandate to some degree as well. Governor Romney wrote the book on an individual mandate when he passed a healthcare reform plan as Governor of Massachusetts, despite the fact that he defends his plan using the "federalism" argument. The 10th amendment may give Constitutional support to what states do, but it doesn't make those things a good idea. Yesterday, Mitt Romney continued to defend his plan, but this time re-iterated its merits on the basis of personal responsibility (as he has done previously). Sensing that Speaker Gingrich is his current competition, Romney noted that Gingrich also had supported the concept of health insurance mandates on the basis of "personal responsibility", noting too that the Heritage Foundation had supported the concept of insurance mandates.

What might make supposedly "conservative" politicians want to have government mandate that individuals purchase a certain product such as health insurance, even under the guise of "personal responsibility"? Doesn't that conflict with the idea of personal liberty that conservatives espouse? Peter Schweizer just published a book, Throw Them All Out, where he spent a whole chapter discussing the relationship between Congressional stock trades and legislation. He discussed how Congressmen purchased stocks in drug companies just before the Medicare Part D legislation was passed in 2003, knowing that the stock prices would rise after the bill was signed into law and they would reap the profits. During Obamacare deliberations, Congressmen purchased stock in health insurance companies once they new the "public option" would be nixed, and insurance stock prices would go up. While neither of these situations focused on a personal mandate, they do suggest that politicians are willing to add layers of bureaucracy and create new government programs for their personal benefit. Speaker Gingrich has expressed support for a personal mandate on multiple occasions, as early as 1993 and as recently as this past May. Why? While Gingrich is indeed opposed to Obamacare and has expressed disapproval of its mandate, he also consulted for drug companies and health insurance companies as part of  his healthcare think tank, which supported insurance mandates, to the tune of millions of dollars. Governor Perry also supported a health care mandate of sorts with his (thankfully overturned) Gardasil mandate, which was essentially political payback for Merck's donations to his campaign and to the RGA. Politicians, even self-proclaimed conservatives, will often advocate for greater government control over healthcare if it helps their pocketbook or their political career.

The idea that personal responsibility lies in the purchase of health insurance, even by the Heritage Foundation, is misplaced. Individuals should be responsible for their own health, not mandated to purchase a product. Government can do little to control or mandate health, but they can do a heck of a lot to mandate health insurance purchase,  create greater bureaucracy, and implement larger regulations. However, people are truly responsible for their own health. The most free market, patient centered healthcare ideas center around the fact that the individual is empowered to make his or her own decisions when it comes to health. This is why things like health savings accounts are well supported by conservatives, as they enable individuals to choose how their money is being spent for a portion of their health care needs.

Beyond this, though, is the needed focus on personal responsibility in health choices in eating and exercise, not because of mandated school lunch programs to help curb childhood obesity proposed by fearmongering liberals, but for the sake of one's own health. While cancers and chronic diseases are often linked to genetics and other factors outside one's control, 40% of cancers and 80% of chronic diseases are preventable.  Choices in exercise, smoking, and nutrition will go along way to help keep an individual healthly. This is not to say that people should not purchase health insurance or accept health coverage from their employer, but simply that it not be the subject of the mandates, nor couched in "personal responsibility" language.  Many laughably defend the health insurance mandate by referencing car insurance mandates (never mind that you're not mandated to own a car).However, if we were to take even that irrational argument further, then health insurance should only cover when you get in an accident, not when you go in for a routine physical, which is akin to an oil change and is not covered by car insurance.People with health insurance are generally healthy, but health insurance does not make one healthy. Making healthy personal choices (without government intervention) is the truest form of personal responsibility, but it sure is a lot harder for politicians to make money off of our own personally responsible choices.

No comments:

Post a Comment